[Nifedipine or nicardipine in management of threatened preterm delivery: an observational population-based study]

Autor: C, Le Ray, F, Maillard, B, Carbonne, E, Verspyck, D, Cabrol, F, Goffinet, Norbert, Winer
Přispěvatelé: Debs, Nayla, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie-obstétrique [CHU Saint-Antoine], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de gynécologie et obstétrique [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), L'enquête EVAPRIMA a été financée par la compagnie pharmaceutique Ferring., groupe EVAPRIMA, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris-Sud - Paris 11 ( UP11 ), CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Service de gynécologie-obstétrique, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Service de gynécologie et obstétrique [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Service de gynécologie-obstétrique [Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Jazyk: francouzština
Rok vydání: 2010
Předmět:
Adult
MESH : Tocolytic Agents
Nifedipine
tocolyse
MESH: Premature Birth
MESH : Young Adult
MESH: Calcium Channel Blockers
MESH : Treatment Outcome
MESH : Randomized Controlled Trials as Topic
MESH: Nicardipine
MESH : Calcium Channel Blockers
nicardipine
Young Adult
MESH: Pregnancy
Pregnancy
Humans
MESH : Female
MESH : France
Randomized Controlled Trials as Topic
MESH: Treatment Outcome
Menace d'accouchement prématuré
MESH: Humans
MESH : Humans
[ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie
MESH: Adult
MESH : Adult
Calcium Channel Blockers
MESH : Nifedipine
MESH: France
MESH : Pregnancy
MESH : Premature Birth
Tocolytic Agents
Treatment Outcome
enquête de pratique
MESH: Randomized Controlled Trials as Topic
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
MESH: Young Adult
Premature Birth
Female
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
France
MESH: Nifedipine
nifédipine
MESH: Female
MESH : Nicardipine
MESH: Tocolytic Agents
Zdroj: Journal de Gynécologie Obstétrique et Biologie de la Reproduction
Journal de Gynécologie Obstétrique et Biologie de la Reproduction, Elsevier Masson, 2010, 39 (6), pp.490-7. ⟨10.1016/j.jgyn.2010.04.004⟩
Journal de Gynécologie Obstétrique et Biologie de la Reproduction, Elsevier Masson, 2010, 39 (6), pp.490-7. 〈10.1016/j.jgyn.2010.04.004〉
Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 2010, 39 (6), pp.490-7. ⟨10.1016/j.jgyn.2010.04.004⟩
ISSN: 0368-2315
DOI: 10.1016/j.jgyn.2010.04.004
Popis: International audience; OBJECTIVE: For the first line tocolysis, calcium channel blockers (CCB)--oral nifedipine (Adalate®) or intravenous nicardipine (Loxen®)--are frequently used in France. No study compared nifedipine and nicardipine in management of threatened preterm delivery. From data of a French observational study, we compared factors associated with the use of nifedipine and nicardipine. Efficacy and tolerance of the two treatments were also compared. METHODS: It was a secondary analysis of EVAPRIMA study, a practice survey describing management of threatened preterm delivery in 107 French maternity units. Only women who received calcium channel blockers in their first line tocolytic therapy were included. We studied obstetrical factors associated with the choice of nifedipine or nicardipine. We also analyzed factors associated with a delivery within seven days following admission using univariate and multivariate analysis. Adverse secondary effects were compared between women who received nifedipine or nicardipine. RESULTS: Three hundred and four women received calcium channel blockers for their first line tocolytic therapy, in 73 maternity units: 93 (30.6%) women received oral nifedipine and 211 (69.4%) intravenous nicardipine. The same CCB was always prescribed in 69 maternity units. Admission after in utero transfer was less frequent among women who received nifedipine (6.5% versus 17.1%, P=0.01). Premature rupture of the membranes was also less frequent among women who received nifedipine (4.3% versus 13.7%, P=0.02), in comparison with women who received nicardipine. Median duration between admission for threatened preterm labor and delivery was longer when nifedipine was used (44 days versus 36 days, P=0.04). After adjustment on obstetrical factors, the risk to have a delivery within 7 days following admission was not significantly different between nifedipine and nicardipine groups (adjusted OR=0.5 [0.2-1.2]). Among women who received nifedipine only two cases (2.1%) of adverse event were reported with only one case needing a switch of treatment. Thirteen (6.2%) cases of adverse event were reported among women who received nicardipine (P=0.16); in three cases it motivated a switch. However, due to bias and limits inherent in such studies, our results should be interpreted cautiously. CONCLUSION: Nicardipine is the first choice for French obstetricians in management of severe threatened preterm delivery. However, intravenous nicardipine does not increase gestational duration in comparison with oral nifedipine.
Databáze: OpenAIRE
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